BVA9506182
DOCKET NO. 93-15 619 ) DATE
)
)
On appeal from the decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Wichita, Kansas
THE ISSUE
Entitlement to an increased rating for post-traumatic stress
disorder (PTSD), currently rated 10 percent disabling.
REPRESENTATION
Appellant represented by: Disabled American Veterans
WITNESS AT HEARING ON APPEAL
Appellant
REMAND
The veteran had active duty from October 1968 to November 1971.
Service connection was granted for PTSD in a July 1992 rating
decision which also assigned a 10 percent rating and listed
"poly-substance abuse" as not service-connected. The veteran
has disagreed with the rating and, in his July 1993 hearing
before the undersigned, raised the issues of service connection
for substance abuse (to include all forms of substance abuse
diagnosed on the discharge summary related to his VA
hospitalization from December 1991 to March 1992) and a total
disability rating based on unemployability.
The discharge summary described above assigned a global
assessment of functioning score of 35. A VA examiner in April
1992 assigned a global assessment of functioning score of 40, and
a social worker described the veteranís social and economic
incapacitation as "serious". Neither the discharge summary nor
the VA examination differentiates the impairment due to PTSD from
that due to other causes. Moreover, during the VA examination
the veteran indicated he was to be rehospitalized in September
1992 for further PTSD treatment. These circumstances require
further development and adjudication.
To ensure that VA has met its duty to assist the appellant in
developing the facts pertinent to the claim, the case is REMANDED
to the RO for the following development:
1. The RO should obtain the names and
addresses of all medical care providers who
treated the veteran for PTSD since his
April 1992 examination. After securing the
necessary release, the RO should obtain
these records, as well as all pertinent VA
inpatient and outpatient records.
2. The veteran should be afforded a VA
psychiatric examination to determine the
severity of his PTSD. The examiner must
assign a Global Assessment of Functioning
Score consistent with the American
Psychiatric Associationís Diagnostic and
Statistical Manual for Mental Disorders
(3rd ed., rev. 1987), and explain what the
assigned score represents. In addition,
the examiner should offer an opinion as to
whether it is at least as likely as not
that one or more of the veteranís substance
abuse disorders are the result of his PTSD.
If not, the examiner should differentiate
the effect of PTSD on the veteranís social
and industrial adaptability from that of
his substance abuse disorders or other
psychiatric diagnoses. A complete
rationale for any opinion expressed must be
provided. The claims folder should be made
available to the examiner for review before
the examination.
3. The RO should then readjudicate the
issue of an increased rating, and
adjudicate the issues of service connection
for substance abuse disorders and a total
rating based on unemployability, including
any further development indicated.
Thereafter, the case should be returned to the Board, if in
order. The Board intimates no opinion as to the ultimate outcome
of this case. The appellant need take no action unless otherwise
notified.
J. E. DAY
Member, Board of Veterans' Appeals
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, ß 6, 108 Stat. 740, ___
(1994), permits a proceeding instituted before the Board to be
assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
Under 38 U.S.C.A. ß 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the Board
on the merits of your appeal. 38 C.F.R. ß 20.1100(b) (1993).